Studying the how and why of therapeutic change: the increasingly prominent role of mediators in group psychotherapy research.

摘要

One of the ongoing critiques regarding psychotherapy outcome studies is their limited relevance or practical utility in the day by day, patient by patient clinical work of psychotherapists (Borkovec & Miranda, 1999; Wachtel, 2010; Westen, Novotny, & Thompson-Brenner, 2004). The typical "horserace" design that compares one brand of therapy to another reveals that something within the experimental condition made a significant difference, but to claim, as often happens, that it is the researcher's touted package of therapeutic components that is the causative agent does not follow scientific logic. A variety of confounding nonspecific and unidentified variables, such as Luborsky's allegiance effect (Luborsky et al., 1999), could just as well be the causal factor that determines the winner.